Évaluation de la pratique des techniques d'anesthésie locorégionale en dehors de l'hôpital et à l'hôpital par les urgentistes d'une région française

The regional anesthesia (LRA) has great benefits in the management of emergency patients. A regional investigation was conducted to estimate the practice of LRA by emergency physicians. This multicenter and descriptive survey was conducted from January 1 to April 30, 2012 in the 46 emergency departments of a French county. One hundred forty-four emergency physicians completed a questionnaire about their training and daily LRA's practice. The rate of participation reached 45% and 71% of doctors practiced LRA. Indications were: pain relief (71%), exploration (60%) or reduction of fracture (52%). There was a statistical association between the experiment of the doctor and the practice of the LRA (P = 0.01). Seventy-two percent of physicians judged the usefulness of LRA. However, the practitioners underlined a lack of training (46%), rare indications (30%), a fear (6%) and a lack of interest (3%). The nerve block realized were: the femoral block (60%), the hand block (21%), the face block (13%) and the footblock (2%). Physicians were: 65% did not know the recommendations and 69% were unaware of lipid emulsions used for treatment of local anesthetic systemic toxicity. Ninety-seven percent of practitioners are interested in a regional training. Ten years after the recommendations, it turns out that there is a lack of knowledge and a real need for training of emergency physicians in the studied county.